Novel and Effective Therapeutic Regimens for Helicobacter pylori in an Era of Increasing Antibiotic Resistance.
Novel and Effective Therapeutic Regimens for Helicobacter pylori in an Era of Increasing Antibiotic Resistance.
复制标题
在抗生素耐药性日益增加的时代，针对幽门螺杆菌的新颖有效的治疗方案
DOI：
10.3389/fcimb.2017.00168
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发表时间：
2017
影响因子：
5.7
通讯作者：
Lu NH
中科院分区：
文献类型：
--
作者：
Hu Y;Zhu Y;Lu NH
幽门螺杆菌（H. pylori）是一种常见的胃肠道细菌菌株，与慢性胃炎、消化性溃疡、胃粘膜相关淋巴组织淋巴瘤和胃癌的发病密切相关。目前的研究和临床挑战是H. pylori，这导致了H.幽门螺杆菌根除率本文综述了近年来H. pylori感染率和再感染率;幽门螺杆菌对抗生素的耐药性，我们讨论相关的治疗。使用以下关键词进行PubMed文献检索：幽门螺杆菌、感染、再感染、抗生素耐药性、铋剂、质子泵抑制剂、沃诺拉赞、敏感性、五联疗法、双联疗法和益生菌。H.尽管幽门螺杆菌呈下降趋势，但在某些地区幽门螺杆菌仍然很高。幽门螺杆菌患病率随时间的变化。此外，H.幽门螺旋杆菌再感染率在不同国家因社会经济和卫生条件而异。幽门螺杆菌对克拉霉素、甲硝唑或左氧氟沙星的单一耐药在大多数国家很常见。然而，阿莫西林和四环素耐药的流行率仍然很低。因为H. pylori感染和再感染提出了严重的挑战，因为H.在大多数国家，幽门螺杆菌对克拉霉素、甲硝唑或左氧氟沙星的耐药性仍然很高，因此选择有效的方案来根除H。幽门螺杆菌是关键。目前，含铋的四联疗法仍然达到很高的根除率。此外，基于易感性的治疗是替代方案，因为它们可以避免使用不必要的抗生素。新的治疗方案，例如，含沃诺拉赞的三联疗法、五联疗法、高剂量双联疗法和含益生菌的标准三联疗法需要进一步研究其治疗H.幽门。
Helicobacter pylori (H. pylori) is a common gastrointestinal bacterial strain closely associated with the incidence of chronic gastritis, peptic ulcers, gastric mucosa-associated lymphoid tissue lymphoma, and gastric cancer. A current research and clinical challenge is the increased rate of antibiotic resistance in H. pylori, which has led to a decreased H. pylori eradication rate. In this article, we review recent H. pylori infection and reinfection rates and H. pylori resistance to antibiotics, and we discuss the pertinent treatments. A PubMed literature search was performed using the following keywords: Helicobacter pylori, infection, reinfection, antibiotic resistance, bismuth, proton pump inhibitors, vonoprazan, susceptibility, quintuple therapy, dual therapy, and probiotic. The prevalence of H. pylori has remained high in some areas despite the decreasing trend of H. pylori prevalence observed over time. Additionally, the H. pylori reinfection rate has varied in different countries due to socioeconomic and hygienic conditions. Helicobacter pylori monoresistance to clarithromycin, metronidazole or levofloxacin was common in most countries. However, the prevalence of amoxicillin and tetracycline resistance has remained low. Because H. pylori infection and reinfection present serious challenges and because H. pylori resistance to clarithromycin, metronidazole or levofloxacin remains high in most countries, the selection of an efficient regimen to eradicate H. pylori is critical. Currently, bismuth-containing quadruple therapies still achieve high eradication rates. Moreover, susceptibility-based therapies are alternatives because they may avoid the use of unnecessary antibiotics. Novel regimens, e.g., vonoprazan-containing triple therapies, quintuple therapies, high-dose dual therapies, and standard triple therapies with probiotics, require further studies concerning their efficiency and safety for treating H. pylori.